First Edition: September 9, 2013

Today's headlines include reports about how Time Warner and IBM are planning to move retirees to private health insurance exchanges to cut costs.

Kaiser Health News: Shopping For Coverage: Health Marketplaces Are Open To Nearly Everyone
In this daily video series, Kaiser Health News consumer columnist Michelle Andrews explains specific parts of how new health exchanges will function, including how – even though they are open to nearly all -- individuals who already have insurance through work, Medicare or Medicaid don’t need to shop there (9/9). Watch the video.

Kaiser Health News: Nurse Practitioners Try New Tack To Expand Foothold In Primary Care
Kaiser Health News staff writer Julie Appleby, working in collaboration with The Philadelphia Inquirer, reports: "Nurse practitioners say efforts to expand primary care to millions of Americans under the health law are hampered by insurance industry practices that limit or exclude their participation. Despite laws in 17 states and the District of Columbia allowing them to practice independently, nurses with advanced degrees say some insurers still don’t accept them into their credentialed networks as primary care providers, while others restrict them mainly to rural areas" (Appleby, 9/8). Read the story.

Kaiser Health News: Capsules: Colorado Exchange Watchdog Likes What It Sees; Minnesota Says Its Marketplace Rates Are Nation’s Lowest So Far
Now on Kaiser Health News’ blog, Colorado Public Radio’s Eric Whitney, working in partnership with KHN and NPR, reports on oversight of Colorado’s health exchange: "Colorado is one of 16 states and the District of Columbia that chose to set up its own exchange, via a bipartisan bill the state passed in 2011. Republicans agreed to vote for it only if it included a special legislative oversight committee that would allow a majority to block exchange funding requests. That hasn’t happened yet, but oversight committee hearings have been testy in the past. Not so last Thursday, the final hearing before the exchange’s opening day October 1. It was remarkable for the praise members from both parties heaped upon exchange leadership" (Whitney 9/9).

Also on the blog, Minnesota Public Radio’s Elizabeth Stawicki, also working in partnership with KHN and NPR, reports on Minnesota’s rates: "Minnesota consumers will be able to buy a health plan for as little as $90.59 per month on MNsure, the new state health insurance marketplace, state Commerce Commissioner Mike Rothman said Friday. Rothman said Minnesota has the lowest average rates for individuals and families compared to the other states that have revealed the costs of their plans thus far (that includes 13 states and the District of Columbia, according to a Kaiser Health News running tally). Data released Friday offered a first look at the new health insurance plans and rates that will be sold on MNsure" (Stawicki, 9/6). Check out what else is on the blog.

Politico: House GOP To Advance Stopgap Spending Bill
Final details have not yet been released, but Republicans have stepped up their activity in anticipation of bringing a bill to the floor next week to keep the government funded into mid-December. The GOP leadership is still debating how to handle the pressure from conservatives for a vote on the CR to cut off all funding for health care reform. But the Centers for Medicare and Medicaid Services, which plays a major role in implementing the president’s initiative, is a prime example of the squeeze on Obama. The president had requested $4.82 billion last year for the CMS "program management" account but then settled for $3.8 billion last spring. … But the CR now would put Obama back at square one and at least $1.4 billion below his request for 2014 (Rogers and Bresnahan, 9/6).

The Washington Post: The Inside Story Of How Obama And Boehner Negotiate
Health-care spending was the big issue. Obama was talking about $400 billion in health-care cuts, while Boehner wanted $600 billion. "Can we split the difference here?" Boehner asked. "Can we land at $500 billion?" "I have to look at not just the numbers on a piece of paper," Obama said, "but what’s behind the numbers." The impact on elderly Medicare beneficiaries could be dramatic if they went too far. “Four hundred billion is it. I just can’t see how we go any further on that.” In a 2:30 phone call that afternoon, Boehner agreed to take increasing the Medicare eligibility age off the table. Obama said he appreciated the offer: "I’m going to give you a counter that gets us closer, so close that it would be silly for us not to get an agreement.” He called back just before 4 p.m. with $120 billion in other concessions. But Boehner realized that the extreme conservatives and tea party element among House Republicans would not go along with any of this (Woodward, 9/6).

Politico: With Obamacare Near, What’s In Store For Workers
With all the hullabaloo over Obamacare, you might think a radical transformation of your health insurance is imminent. But the noisy claims from both sides notwithstanding, the reality is that the changes next year are likely to be pretty subtle for the vast majority of the 170 million who get insurance through the workplace (Norman, 9/9).

Politico: Health Insurance Tax Faces Challenge
The health insurance industry and business allies are stepping up their campaign to repeal another new Obamacare tax this fall — one that they argue will hit consumers smack in the health care part of their wallet. As Congress returns from recess, expect to hear more about the health insurance tax, or HIT, as it’s known, a levy in the health care law to raise $116 billion through 2023. That money, in turn, is supposed to help finance expanded coverage (Norman, 9/9).

The Washington Post’s Wonk Blog: Left Behind: Stories From Obamacare’s 31 Million Uninsured
The Affordable Care Act, the most sweeping health care program created in a half century, is expected to extend coverage to 25 million Americans over the next decade, according to the most recent government estimates. But that will still leave a projected 31 million people without insurance by 2023. Those left out include undocumented workers and poor people living in the 21 states, such as Virginia, that have so far declined to expand Medicaid under the statute, commonly called Obamacare (Kliff and Sun, 9/8).

The Washington Post: Yes, We Know Premium Prices Under Obamacare. No, We Don’t Know If People Will Think They’re Affordable.
Premium subsidies may be one of the most complicated parts of the Affordable Care Act to understand, and that says something when you’re talking about a 2,000-page law that overhauls the American health-care system. They’re also crucially important to the health care law, the factors that determines how much health insurance will cost under Obamacare and whether Americans will decide that price tag is affordable. So, today, we’re going to use a brand new report from the Kaiser Family Foundation to explain how the subsidies work (Kliff, 9/6).

Los Angeles Times: As Healthcare Law Rolls Out, Its Effects Will Depend On Your State
Americans who live in states backing the Affordable Care Act will receive substantial protections and assistance unavailable to residents in states still fighting the 2010 law. That could mean confusion and higher insurance premiums for millions of consumers in states resisting the law. Leaders in these resistant states have not set up consumer hot lines. Several state insurance regulators are refusing to make sure health plans offer new protections required by the law, such as guaranteed coverage for people who are ill (Levey, 9/6).

Politico: In Hawaii, Firms Like Longtime Employer Mandate
Obamacare’s requirement that large companies offer health insurance may be polarizing for much of the nation — but it had Hawaiians at Aloha. Unlike its 49 counterparts, Hawaii has been living with a strict employer mandate for nearly 40 years. And as businesses nationwide celebrate a one-year delay in the similar Obamacare requirement that they cover workers, supporters of Hawaii’s law say theirs is proof that the rest of the country could adjust — and even learn to like it (Cheney, 9/9).

The New York Times: Insurance Rolls To Rise In State Fighting Plan
In her State of the State speech in January, Gov. Nikki R. Haley, a Republican, said, “South Carolina will not implement the public policy disaster that is Obamacare’s Medicaid expansion.” ... The reality, however, is more complex. South Carolina officials say they welcome the prospect that more than a half-million state residents — out of a population of 4.7 million — could soon gain access to affordable coverage, even without the expansion of Medicaid eligibility. And they are working to remake Medicaid so that it does not just pay claims but produces measurable improvements in the health of poor people (Pear, 9/6).

The Associated Press/Washington Post: Nonprofit Groups Rush To Hire, Train ‘Obamacare’ Experts With Just Three Weeks To Go
With the program known as “Obamacare” only weeks away from its key launch date, hectic preparations are in motion in communities across the country to deal with one of its major practical challenges: hiring and training a small army of instant experts who can explain the intricacies of health insurance to people who’ve never had it. More than 100 nonprofits and related organizations, which specialize in everything from running soup kitchens to organizing farm workers, have been recruited by the federal government to sign up “navigators” to help the 30 million uninsured people who can now gain coverage (9/9).

The Associated Press/Washington Post: WVa Nonprofit Declined Federal Grant After AG Asks Questions, Va Group Accepts Funding
A West Virginia nonprofit has turned down a federal grant it received to help residents navigate new health insurance options under the Affordable Care Act after it received an inquiry from Attorney General Patrick Morrisey about how it would protect consumer information (9/8).

The Wall Street Journal: Don't Confuse Medicare With Obamacare
The annual Medicare open-enrollment period, which runs from Oct. 15 through Dec. 7, overlaps this year with the initial registration for the Health Insurance Marketplace, a cornerstone of the Affordable Care Act (aka Obamacare). But don't confuse the two. They serve different populations. If you're already covered by Medicare, you needn't give the Marketplace another thought (Waters, 9/7).

The Associated Press/Wall Street Journal: Rochester, NY, Cited For Lowest Medicare Spending
A new study finds that the Rochester area has the lowest overall Medicare spending rate in the nation, a feat health officials attribute to aggressive regional planning that keeps a lid on unneeded hospital expansions and technology upgrades that insurers ultimately pay for (9/8).

The Associated Press: How To Invest In Your Health Care
You already can invest your retirement money and your kid's college savings on Wall Street. Next on the list: your health care. A growing number of employees are required by companies to set up special savings accounts to cover part of their medical bills. Over time, they are also encouraged to invest a portion of it in stocks, bonds or a mutual fund, just like they do with a 401(k) or IRA. Americans now have $18 billion in Health Savings Accounts. … That's up more than 40 percent from a year ago (Sweet, 9/6).

The Associated Press: IBM Moving Some Retirees Off Its Health Plan
IBM plans to move many retired workers off its health plan and give them money to buy coverage on a health-insurance exchange. The move is part of a corporate trend away from providing traditional retiree health benefits as costs rise. The company says it acted after projections showed that costs under its current plan for Medicare-eligible retirees will triple by 2020 and that the increases would be paid by retirees through premiums and out-of-pocket costs (Koenig, 9/7).

The Wall Street Journal: IBM To Move Retirees Off Health Plan
IBM's shift is an indication that health-insurance marketplaces, similar to the public exchanges proposed under President Barack Obama's health-care overhaul, will play a bigger role as companies move coverage down the path taken by many pensions, paying employees and retirees a fixed sum to manage their own care. In notices signed by Chief Health Director Kyu Rhee, IBM has told retirees in recent weeks that to keep receiving coverage, they will need to pick a plan offered through Extend Health, a large private Medicare exchange run by New York-based Towers Watson & Co. (Ante, 9/7).

The Associated Press/Washington Post: Time Warner Joins IBM In Moving Retirees To Private Health Insurance Exchanges To Cut Costs
Media and entertainment company Time Warner Inc. plans to move its retired workers off its health plan and provide money to them to purchase coverage on private exchanges at the beginning of next year (9/8).

The Wall Street Journal: Time Warner Joins IBM In Health Shift For Retirees
Insurance exchanges are the health-care experiment du jour. Retirees are the test case. The latest indication: Media-company Time Warner Inc. plans to move its U.S. retirees from company-administered health plans to private exchanges, according to a person familiar with the matter. The company will allocate funds in special accounts that retirees can use to go shop for coverage, the person said (Ante, 9/8).

The New York Times: Debating A Fix For Hospitals In Dire Straits
Of all the issues in the Democratic primary for mayor, one of the few that most candidates seem to agree on is that struggling New York City hospitals need to be saved. ... Despite the discourse, it is the state that regulates hospitals and gives the grants and loans needed to keep them from failing. And Gov. Andrew M. Cuomo is not throwing the hospitals a lifeline (Hartocollis, 9/6).

Check out all of Kaiser Health News' e-mail options including First Edition and Breaking News alerts on our Subscriptions page.

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.